Robotic in situ 3D bio-printing technology for repairing large segmental bone defects

Recent advances and applications of artificial intelligence in 3D bioprinting

3D bioprinting techniques enable the precise deposition of living cells, biomaterials, and biomolecules, emerging as a promising approach for engineering functional tissues and organs. Meanwhile, recent advances in 3D bioprinting enable researchers to build in vitro models with finely controlled and complex micro-architecture for drug screening and disease modeling. Recently, artificial intelligence (AI) has been applied to different stages of 3D bioprinting, including medical image reconstruction, bioink selection, and printing process, with both classical AI and machine learning approaches. The ability of AI to handle complex datasets, make complex computations, learn from past experiences, and optimize processes dynamically makes it an invaluable tool in advancing 3D bioprinting. The review highlights the current integration of AI in 3D bioprinting and discusses future approaches to harness the synergistic capabilities of 3D bioprinting and AI for developing personalized tissues and organs.

Conformal 3D Printing Algorithm for Surfaces and Its In Situ Repair Applications

Conformal 3D printing can construct specific three-dimensional structures on the free-form surfaces of target objects, achieving in situ additive manufacturing and repair, making it one of the cutting-edge technologies in the current field of 3D printing. To further improve the repair efficacy in tissue engineering, this study proposes a conformal path planning algorithm for in situ printing in specific areas of the target object. By designing the conformal 3D printing algorithm and utilizing vector projection and other methods, coordinate transformation of the printing trajectory was achieved. The algorithm was validated, showing good adherence of the printing material to the target surface. In situ repair experiments were also conducted on human hands and pig tibia defect models, verifying the feasibility of this method and laying a foundation for further research in personalized medicine and tissue repair.

Towards Stem Cell Therapy for Critical-Sized Segmental Bone Defects: Current Trends and Challenges on the Path to Clinical Translation

The management and reconstruction of critical-sized segmental bone defects remain a major clinical challenge for orthopaedic clinicians and surgeons. In particular, regenerative medicine approaches that involve incorporating stem cells within tissue engineering scaffolds have great promise for fracture management. This narrative review focuses on the primary components of bone tissue engineering-stem cells, scaffolds, the microenvironment, and vascularisation-addressing current advances and translational and regulatory challenges in the current landscape of stem cell therapy for critical-sized bone defects. To comprehensively explore this research area and offer insights for future treatment options in orthopaedic surgery, we have examined the latest developments and advancements in bone tissue engineering, focusing on those of clinical relevance in recent years. Finally, we present a forward-looking perspective on using stem cells in bone tissue engineering for critical-sized segmental bone defects.

In Situ Bioprinting: Process, Bioinks, and Applications

Traditional tissue engineering methods face challenges, such as fabrication, implantation of irregularly shaped scaffolds, and limited accessibility for immediate healthcare providers. In situ bioprinting, an alternate strategy, involves direct deposition of biomaterials, cells, and bioactive factors at the site, facilitating on-site fabrication of intricate tissue, which can offer a patient-specific personalized approach and align with the principles of precision medicine. It can be applied using a handled device and robotic arms to various tissues, including skin, bone, cartilage, muscle, and composite tissues. Bioinks, the critical components of bioprinting that support cell viability and tissue development, play a crucial role in the success of in situ bioprinting. This review discusses in situ bioprinting techniques, the materials used for bioinks, and their critical properties for successful applications. Finally, we discuss the challenges and future trends in accelerating in situ printing to translate this technology in a clinical settings for personalized regenerative medicine.

Gelatin Methacryloyl (GelMA)-Based Biomaterial Inks: Process Science for 3D/4D Printing and Current Status

Tissue engineering for injured tissue replacement and regeneration has been a subject of investigation over the last 30 years, and there has been considerable interest in using additive manufacturing to achieve these goals. Despite such efforts, many key questions remain unanswered, particularly in the area of biomaterial selection for these applications as well as quantitative understanding of the process science. The strategic utilization of biological macromolecules provides a versatile approach to meet diverse requirements in 3D printing, such as printability, buildability, and biocompatibility. These molecules play a pivotal role in both physical and chemical cross-linking processes throughout the biofabrication, contributing significantly to the overall success of the 3D printing process. Among the several bioprintable materials, gelatin methacryloyl (GelMA) has been widely utilized for diverse tissue engineering applications, with some degree of success. In this context, this review will discuss the key bioengineering approaches to identify the gelation and cross-linking strategies that are appropriate to control the rheology, printability, and buildability of biomaterial inks. This review will focus on the GelMA as the structural (scaffold) biomaterial for different tissues and as a potential carrier vehicle for the transport of living cells as well as their maintenance and viability in the physiological system. Recognizing the importance of printability toward shape fidelity and biophysical properties, a major focus in this review has been to discuss the qualitative and quantitative impact of the key factors, including microrheological, viscoelastic, gelation, shear thinning properties of biomaterial inks, and printing parameters, in particular, reference to 3D extrusion printing of GelMA-based biomaterial inks. Specifically, we emphasize the different possibilities to regulate mechanical, swelling, biodegradation, and cellular functionalities of GelMA-based bio(material) inks, by hybridization techniques, including different synthetic and natural biopolymers, inorganic nanofillers, and microcarriers. At the close, the potential possibility of the integration of experimental data sets and artificial intelligence/machine learning approaches is emphasized to predict the printability, shape fidelity, or biophysical properties of GelMA bio(material) inks for clinically relevant tissues.

Advances in 3D bioprinting for regenerative medicine applications

Biofabrication techniques allow for the construction of biocompatible and biofunctional structures composed from biomaterials, cells and biomolecules. Bioprinting is an emerging 3D printing method which utilizes biomaterial-based mixtures with cells and other biological constituents into printable suspensions known as bioinks. Coupled with automated design protocols and based on different modes for droplet deposition, 3D bioprinters are able to fabricate hydrogel-based objects with specific architecture and geometrical properties, providing the necessary environment that promotes cell growth and directs cell differentiation towards application-related lineages. For the preparation of such bioinks, various water-soluble biomaterials have been employed, including natural and synthetic biopolymers, and inorganic materials. Bioprinted constructs are considered to be one of the most promising avenues in regenerative medicine due to their native organ biomimicry. For a successful application, the bioprinted constructs should meet particular criteria such as optimal biological response, mechanical properties similar to the target tissue, high levels of reproducibility and printing fidelity, but also increased upscaling capability. In this review, we highlight the most recent advances in bioprinting, focusing on the regeneration of various tissues including bone, cartilage, cardiovascular, neural, skin and other organs such as liver, kidney, pancreas and lungs. We discuss the rapidly developing co-culture bioprinting systems used to resemble the complexity of tissues and organs and the crosstalk between various cell populations towards regeneration. Moreover, we report on the basic physical principles governing 3D bioprinting, and the ideal bioink properties based on the biomaterials' regenerative potential. We examine and critically discuss the present status of 3D bioprinting regarding its applicability and current limitations that need to be overcome to establish it at the forefront of artificial organ production and transplantation.

Future trends of additive manufacturing in medical applications: An overview

Additive Manufacturing (AM) has recently demonstrated significant medical progress. Due to advancements in materials and methodologies, various processes have been developed to cater to the medical sector's requirements, including bioprinting and 4D, 5D, and 6D printing. However, only a few studies have captured these emerging trends and their medical applications. Therefore, this overview presents an analysis of the advancements and achievements obtained in AM for the medical industry, focusing on the principal trends identified in the annual report of AM3DP.

Current Biomedical Applications of 3D-Printed Hydrogels

Three-dimensional (3D) printing, also known as additive manufacturing, has revolutionized the production of physical 3D objects by transforming computer-aided design models into layered structures, eliminating the need for traditional molding or machining techniques. In recent years, hydrogels have emerged as an ideal 3D printing feedstock material for the fabrication of hydrated constructs that replicate the extracellular matrix found in endogenous tissues. Hydrogels have seen significant advancements since their first use as contact lenses in the biomedical field. These advancements have led to the development of complex 3D-printed structures that include a wide variety of organic and inorganic materials, cells, and bioactive substances. The most commonly used 3D printing techniques to fabricate hydrogel scaffolds are material extrusion, material jetting, and vat photopolymerization, but novel methods that can enhance the resolution and structural complexity of printed constructs have also emerged. The biomedical applications of hydrogels can be broadly classified into four categories-tissue engineering and regenerative medicine, 3D cell culture and disease modeling, drug screening and toxicity testing, and novel devices and drug delivery systems. Despite the recent advancements in their biomedical applications, a number of challenges still need to be addressed to maximize the use of hydrogels for 3D printing. These challenges include improving resolution and structural complexity, optimizing cell viability and function, improving cost efficiency and accessibility, and addressing ethical and regulatory concerns for clinical translation.

Nano-biomaterials and advanced fabrication techniques for engineering skeletal muscle tissue constructs in regenerative medicine

Engineered three-dimensional (3D) tissue constructs have emerged as a promising solution for regenerating damaged muscle tissue resulting from traumatic or surgical events. 3D architecture and function of the muscle tissue constructs can be customized by selecting types of biomaterials and cells that can be engineered with desired shapes and sizes through various nano- and micro-fabrication techniques. Despite significant progress in this field, further research is needed to improve, in terms of biomaterials properties and fabrication techniques, the resemblance of function and complex architecture of engineered constructs to native muscle tissues, potentially enhancing muscle tissue regeneration and restoring muscle function. In this review, we discuss the latest trends in using nano-biomaterials and advanced nano-/micro-fabrication techniques for creating 3D muscle tissue constructs and their regeneration ability. Current challenges and potential solutions are highlighted, and we discuss the implications and opportunities of a future perspective in the field, including the possibility for creating personalized and biomanufacturable platforms.

Customized Additive Manufacturing in Bone Scaffolds-The Gateway to Precise Bone Defect Treatment

In the advancing landscape of technology and novel material development, additive manufacturing (AM) is steadily making strides within the biomedical sector. Moving away from traditional, one-size-fits-all implant solutions, the advent of AM technology allows for patient-specific scaffolds that could improve integration and enhance wound healing. These scaffolds, meticulously designed with a myriad of geometries, mechanical properties, and biological responses, are made possible through the vast selection of materials and fabrication methods at our disposal. Recognizing the importance of precision in the treatment of bone defects, which display variability from macroscopic to microscopic scales in each case, a tailored treatment strategy is required. A patient-specific AM bone scaffold perfectly addresses this necessity. This review elucidates the pivotal role that customized AM bone scaffolds play in bone defect treatment, while offering comprehensive guidelines for their customization. This includes aspects such as bone defect imaging, material selection, topography design, and fabrication methodology. Additionally, we propose a cooperative model involving the patient, clinician, and engineer, thereby underscoring the interdisciplinary approach necessary for the effective design and clinical application of these customized AM bone scaffolds. This collaboration promises to usher in a new era of bioactive medical materials, responsive to individualized needs and capable of pushing boundaries in personalized medicine beyond those set by traditional medical materials.

Pathophysiological mechanism of acute bone loss after fracture

BACKGROUND

Acute bone loss after fracture is associated with various effects on the complete recovery process and a risk of secondary fractures among patients. Studies have reported similarities in pathophysiological mechanisms involved in acute bone loss after fractures and osteoporosis. However, given the silence nature of bone loss and bone metabolism complexities, the actual underlying pathophysiological mechanisms have yet to be fully elucidated.

AIM OF REVIEW

To elaborate the latest findings in basic research with a focus on acute bone loss after fracture. To briefly highlight potential therapeutic targets and current representative drugs. To arouse researchers' attention and discussion on acute bone loss after fracture.

KEY SCIENTIFIC CONCEPTS OF REVIEW

Bone loss after fracture is associated with immobilization, mechanical unloading, blood supply damage, sympathetic nerve regulation, and crosstalk between musculoskeletals among other factors. Current treatment strategies rely on regulation of osteoblasts and osteoclasts, therefore, there is a need to elucidate on the underlying mechanisms of acute bone loss after fractures to inform the development of efficacious and safe drugs. In addition, attention should be paid towards ensuring long-term skeletal health.

In vivo bioprinting: Broadening the therapeutic horizon for tissue injuries

Tissue injury is a collective term for various disorders associated with organs and tissues induced by extrinsic or intrinsic factors, which significantly concerns human health. In vivo bioprinting, an emerging tissue engineering approach, allows for the direct deposition of bioink into the defect sites inside the patient's body, effectively addressing the challenges associated with the fabrication and implantation of irregularly shaped scaffolds and enabling the rapid on-site management of tissue injuries. This strategy complements operative therapy as well as pharmacotherapy, and broadens the therapeutic horizon for tissue injuries. The implementation of in vivo bioprinting requires targeted investigations in printing modalities, bioinks, and devices to accommodate the unique intracorporal microenvironment, as well as effective integrations with intraoperative procedures to facilitate its clinical application. In this review, we summarize the developments of in vivo bioprinting from three perspectives: modalities and bioinks, devices, and clinical integrations, and further discuss the current challenges and potential improvements in the future.

Harnessing Biofabrication Strategies to Re-Surface Osteochondral Defects: Repair, Enhance, and Regenerate

Osteochondral tissue (OC) is a complex and multiphasic system comprising cartilage and subchondral bone. The discrete OC architecture is layered with specific zones characterized by different compositions, morphology, collagen orientation, and chondrocyte phenotypes. To date, the treatment of osteochondral defects (OCD) remains a major clinical challenge due to the low self-regenerative capacity of damaged skeletal tissue, as well as the critical lack of functional tissue substitutes. Current clinical approaches fail to fully regenerate damaged OC recapitulating the zonal structure while granting long-term stability. Thus, the development of new biomimetic treatment strategies for the functional repair of OCDs is urgently needed. Here, we review recent developments in the preclinical investigation of novel functional approaches for the resurfacing of skeletal defects. The most recent studies on preclinical augmentation of OCDs and highlights on novel studies for the in vivo replacement of diseased cartilage are presented.

Application of photocrosslinkable hydrogels based on photolithography 3D bioprinting technology in bone tissue engineering

Bone tissue engineering (BTE) has been proven to be an effective method for the treatment of bone defects caused by different musculoskeletal disorders. Photocrosslinkable hydrogels (PCHs) with good biocompatibility and biodegradability can significantly promote the migration, proliferation and differentiation of cells and have been widely used in BTE. Moreover, photolithography 3D bioprinting technology can notably help PCHs-based scaffolds possess a biomimetic structure of natural bone, meeting the structural requirements of bone regeneration. Nanomaterials, cells, drugs and cytokines added into bioinks can enable different functionalization strategies for scaffolds to achieve the desired properties required for BTE. In this review, we demonstrate a brief introduction of the advantages of PCHs and photolithography-based 3D bioprinting technology and summarize their applications in BTE. Finally, the challenges and potential future approaches for bone defects are outlined.

Bioinks adapted for in situ bioprinting scenarios of defect sites: a review

In situ bioprinting provides a reliable solution to the problem of in vitro tissue culture and vascularization by printing tissue directly at the site of injury or defect and maturing the printed tissue using the natural cell microenvironment in vivo. As an emerging field, in situ bioprinting is based on computer-assisted scanning results of the defect site and is able to print cells directly at this site with biomaterials, bioactive factors, and other materials without the need to transfer prefabricated grafts as with traditional in vitro 3D bioprinting methods, and the resulting grafts can accurately adapt to the target defect site. However, one of the important reasons hindering the development of in situ bioprinting is the absence of suitable bioinks. In this review, we will summarize bioinks developed in recent years that can adapt to in situ printing scenarios at the defect site, considering three aspects: the in situ design strategy of bioink, the selection of commonly used biomaterials, and the application of bioprinting to different treatment scenarios.

Scaffold Guided Bone Regeneration for the Treatment of Large Segmental Defects in Long Bones

Bone generally displays a high intrinsic capacity to regenerate. Nonetheless, large osseous defects sometimes fail to heal. The treatment of such large segmental defects still represents a considerable clinical challenge. The regeneration of large bone defects often proves difficult, since it relies on the formation of large amounts of bone within an environment impedimental to osteogenesis, characterized by soft tissue damage and hampered vascularization. Consequently, research efforts have concentrated on tissue engineering and regenerative medical strategies to resolve this multifaceted challenge. In this review, we summarize, critically evaluate, and discuss present approaches in light of their clinical relevance; we also present future advanced techniques for bone tissue engineering, outlining the steps to realize for their translation from bench to bedside. The discussion includes the physiology of bone healing, requirements and properties of natural and synthetic biomaterials for bone reconstruction, their use in conjunction with cellular components and suitable growth factors, and strategies to improve vascularization and the translation of these regenerative concepts to in vivo applications. We conclude that the ideal all-purpose material for scaffold-guided bone regeneration is currently not available. It seems that a variety of different solutions will be employed, according to the clinical treatment necessary.

Robotic-assisted automated in situ bioprinting

In situ bioprinting has emerged as a promising technology for tissue and organ engineering based on the precise positioning of living cells, growth factors, and biomaterials. Rather than traditional in vitro reconstruction and recapitulation of tissue or organ models, the in situ technology can directly print on specific anatomical positions in living bodies. The requirements for biological activity, function, and mechanical property in an in vivo setting are more complex. By combining progressive innovations of biomaterials, tissue engineering, and digitalization, especially robotics, in situ bioprinting has gained significant interest from the academia and industry, demonstrating its prospect for clinical studies. This article reviews the progress of in situ bioprinting, with an emphasis on robotic-assisted studies. The main modalities for in situ three-dimensional bioprinting, which include extrusion-based printing, inkjet printing, laser-based printing, and their derivatives, are briefly introduced. These modalities have been integrated with various custom-tailored printers (i.e., end effectors) mounted on robotic arms for dexterous and precision biofabrication. The typical prototypes based on various robot configurations, including Cartesian, articulated, and parallel mechanisms, for in situ bioprinting are discussed and compared. The conventional and most recent applications of robotic-assisted methods for in situ fabrication of tissue and organ models, including cartilage, bone, and skin, are also elucidated, followed by a discussion on the existing challenges in this field with their corresponding suggestions.

Covalent immobilization of VEGF on allogeneic bone through polydopamine coating to improve bone regeneration

Objective: Promoting bone regeneration and repairing in bone defects is of great significance in clinical work. Using a simple and effective surface treatment method to enhance the osteogenic ability of existing bone scaffold is a promising method. In this article, we study the application of catecholic amino acid 3,4-dihydroxyphenylalanine (DOPA) surface coating chelated with vascular endothelial growth factor (VEGF) on allogeneic bone.

Method: Allogeneic bone is immersed in DOPA solution and DOPA form polydopamine (PDA) with good adhesion. Electron microscopy is used to characterize the surface characteristics of allogeneic bone. MC3T3-E1 cells were tested for biocompatibility and osteogenic signal expression. Finally, a 12-week rabbit bone defect model was established to evaluate bone regeneration capability.

Results: We found that the surface microenvironment of DOPA bonded allogeneic bone was similar to the natural allogeneic bone. VEGF loaded allografts exhibited satisfying biocompatibility and promoted the expression of osteogenic related signals in vitro. The VEGF loaded allografts healed the bone defect after 12 weeks of implantation that continuous and intact bone cortex was observed.

Conclusion: The PDA coating is a simple surface modification method and has mild properties and high adhesion. Meanwhile, the PDA coating can act on the surface modification of different materials. This study provides an efficient surface modification method for enhancing bone regeneration by PDA coating, which has a high potential for translational clinical applications.

In situ bioprinting: intraoperative implementation of regenerative medicine

Bioprinting has emerged as a strong tool for devising regenerative therapies to address unmet medical needs. However, the translation of conventional in vitro bioprinting approaches is partially hindered due to challenges associated with the fabrication and implantation of irregularly shaped scaffolds and their limited accessibility for immediate treatment by healthcare providers. An alternative strategy that has recently drawn significant attention is to directly print the bioink into the patient's body, so-called 'in situ bioprinting'. The bioprinting strategy and the associated bioink need to be specifically designed for in situ bioprinting to meet the particular requirements of direct deposition in vivo. In this review, we discuss the developed in situ bioprinting strategies, their advantages, challenges, and possible future improvements.

Current Perspectives on the Management of Bone Fragments in Open Tibial Fractures: New Developments and Future Directions

Open tibial fractures may be associated with bone loss at the time of the injury or following surgical debridement of the fracture. This article discusses the various treatment options available and the latest developments surrounding the management of free bone fragments in open tibial fractures.

Advances in 3D bioprinting of tissues/organs for regenerative medicine and in-vitro models

Tissue/organ shortage is a major medical challenge due to donor scarcity and patient immune rejections. Furthermore, it is difficult to predict or mimic the human disease condition in animal models during preclinical studies because disease phenotype differs between humans and animals. Three-dimensional bioprinting (3DBP) is evolving into an unparalleled multidisciplinary technology for engineering three-dimensional (3D) biological tissue with complex architecture and composition. The technology has emerged as a key driver by precise deposition and assembly of biomaterials with patient's/donor cells. This advancement has aided in the successful fabrication of in vitro models, preclinical implants, and tissue/organs-like structures. Here, we critically reviewed the current state of 3D-bioprinting strategies for regenerative therapy in eight organ systems, including nervous, cardiovascular, skeletal, integumentary, endocrine and exocrine, gastrointestinal, respiratory, and urinary systems. We also focus on the application of 3D bioprinting to fabricated in vitro models to study cancer, infection, drug testing, and safety assessment. The concept of in situ 3D bioprinting is discussed, which is the direct printing of tissues at the injury or defect site for reparative and regenerative therapy. Finally, issues such as scalability, immune response, and regulatory approval are discussed, as well as recently developed tools and technologies such as four-dimensional and convergence bioprinting. In addition, information about clinical trials using 3D printing has been included.

Influence of Exposure Period and Angle Alteration on the Flexural Resilience and Mechanical Attributes of Photosensitive Resin

Despite the large number of studies addressing the effect of acrylic resin polymerization concerning flexural properties, limited research has been conducted on the manufacturing impact on a polymer’s mechanical properties. Photosensitive resinous materials are used in various engineering applications where they may be exposed to multiple detrimental environments during their lifetime. Therefore, there is a need to understand the impact of an environment on the service life of resins. Thus, flexural tests were conducted to study the effects of exposure time and angle on the flexural strength of resins. Herein, the main objective was to explore the strength, stability, and flexural durability of photosensitive resin (EPIC-2000ST) fabricated at different exposure times (E) and angle deviation varying from 0° to 85° with a 5° increment. The samples in circular rings were manufactured and divided into five groups according to their exposure time (E): 10 s, 20 s, 30 s, 40 s, and 50 s. In each exposure time, we designed rings via SolidWorks software and experimentally fabricated at different oblique angles (OA) varying from 0° to 85° with a 5° increment during each fabrication, i.e., OA = 0°, 5°, 10°, 15°, 20°, 25°, 30°, 35°, 40°, 45°, 50°, 55°, 60°, 65°, 70°, 75°, 80°, and 85°. Flexural strength was evaluated using a three-point bending test. Optical electron microscopy was used to examines the samples’ exterior, interior, and ruptured surfaces. Our experimental analysis shows that flexural strength was significantly enhanced by increasing exposure time and at higher oblique angles. However, at lower angles and less exposure time, mechanical flexural resilience declines.

In Situ Growth of a Metal-Organic Framework on Graphene Oxide for the Chemo-Photothermal Therapy of Bacterial Infection in Bone Repair

Bacterial infection with high morbidity (>30%) seriously affects the defect's healing after bone transplantation. To this end, chemotherapy and photothermal therapy have been utilized for antibacterial treatment owing to their high selectivity and minimal toxicity. However, they also face several dilemmas. For example, bacterial biofilms prevented the penetration of antibacterial agents and local temperatures (over 70 °C) caused by the photothermal therapy damaged normal tissue. Herein, a co-dispersion nanosystem with chemo-photothermal function was constructed via the in situ growth of zeolitic imidazolate framework-8 (ZIF-8) on graphene oxide (GO) nanosheets. In this nanosystem, GO generates a local temperature (∼50 °C) to increase the permeability of a bacterial biofilm under near-infrared laser irradiation. Then, Zn ions released by ZIF-8 seized this chance to react with the bacterial membrane and inactivate it, thus realizing efficient sterilization in a low-temperature environment. This antibacterial system was incorporated into a poly-l-lactic acid scaffold for bone repair. Results showed that the scaffold showed a high antibacterial rate of 85% against both Escherichia coli and Staphylococcus aureus. In vitro cell tests showed that the scaffold promoted cell proliferation.

Microstructure and Corrosion Behavior of Iron Based Biocomposites Prepared by Laser Additive Manufacturing

Iron (Fe) has attracted great attention as bone repair material owing to its favorable biocompatibility and mechanical properties. However, it degrades too slowly since the corrosion product layer prohibits the contact between the Fe matrix and body fluid. In this work, zinc sulfide (ZnS) was introduced into Fe bone implant manufactured using laser additive manufacturing technique. The incorporated ZnS underwent a disproportionation reaction and formed S-containing species, which was able to change the film properties including the semiconductivity, doping concentration, and film dissolution. As a result, it promoted the collapse of the passive film and accelerated the degradation rate of Fe matrix. Immersion tests proved that the Fe matrix experienced severe pitting corrosion with heavy corrosion product. Besides, the in vitro cell testing showed that Fe/ZnS possessed acceptable cell viabilities. This work indicated that Fe/ZnS biocomposite acted as a promising candidate for bone repair material.

A Biomimetic Platelet-Rich Plasma-Based Interpenetrating Network Printable Hydrogel for Bone Regeneration

Repair of bone defects caused by trauma or diseases is the primary focus of prosthodontics. Hydrogels are among the most promising candidates for bone tissue regeneration due to their unique features such as excellent biocompatibility, similarities to biological tissues, and plasticity. Herein, we developed a type of novel biomimetic interpenetrating polymeric network (IPN) hydrogel by combining methacrylated alginate and 4-arm poly (ethylene glycol)-acrylate (4A-PEGAcr) through photo-crosslinking. Platelet-rich plasma (PRP), a patient-specific source of autologous growth factors, was incorporated into the hydrogel, and thereafter the hydrogels were biological mineralized by simulated body fluid (SBF). Physical properties of hydrogels were comprehensively characterized. In vitro studies demonstrated that the incorporation of PRP and biomineralization promoted the biocompatibility of hydrogel. Strikingly, the osteogenic bioactivities, including ALP activity, mineralized nodule formation, and expression of osteogenic markers were found substantially enhanced by this biomineralized PRP-hydrogel. Finally, a rabbit model of bone defect was employed to assess in vivo bone regeneration, micro-CT analysis showed that the biomineralized PRP-hydrogels could significantly accelerate bone generation. We believed that this novel biomineralized PRP-incorporated IPN hydrogel could be promising scaffolds for bone tissue regeneration.

Injectable Photo-Crosslinked Bioactive BMSCs-BMP2-GelMA Scaffolds for Bone Defect Repair

Injectable hydrogels offer a new therapy option for irregular bone deformities. Based on gelatin methacryloyl (GelMA), bone marrow mesenchymal stem cells (BMSCs), and bone morphogenetic protein 2 (BMP2), we created a photo-crosslinked composite bioactive scaffold. The composite scaffolds had appropriate mechanical properties for stem cells adhesion and proliferation, as well as good biocompatibility and the ability to stimulate BMSCs osteogenic differentiation in vitro. The synergistic effect of BMSCs and BMP2 enabled the composite bioactive scaffold to exhibit higher osteogenic potential in vivo than scaffolds loaded alone with BMSCs or BMP2, according to imaging and histology studies. In conclusion, by promoting the osteogenic differentiation of BMSCs, the composite bioactive scaffold based on BMSCs-BMP2-GelMA has demonstrated remarkable application potential in bone regeneration and bone defects repair.

[Research progress of in-situ three dimensional bio-printing technology for repairing bone and cartilage injuries]

OBJECTIVE

To review the research progress of in-situ three dimensional (3D) bio-printing technology in the repair of bone and cartilage injuries.

METHODS

Literature on the application of in-situ 3D bio-printing technology to repair bone and cartilage injuries at home and abroad in recent years was reviewed, analyzed, and summarized.

RESULTS

As a new tissue engineering technology, in-situ 3D bio-printing technology is mainly applied to repair bone, cartilage, and skin tissue injuries. By combining biomaterials, bioactive substances, and cells, tissue is printed directly at the site of injury or defect. At present, the research on the technology mainly focuses on printing mode, bio-ink, and printing technology; the application research in the field of bone and cartilage mainly focuses on pre-vascularization, adjusting the composition of bio-ink, improving scaffold structure, printing technology, loading drugs, cells, and bioactive factors, so as to promote tissue injury repair.

CONCLUSION

Multiple animal experiments have confirmed that in-situ 3D bio-printing technology can construct bone and cartilage tissue grafts in a real-time, rapid, and minimally invasive manner. In the future, it is necessary to continue to develop bio-inks suitable for specific tissue grafts, as well as combine with robotics, fusion imaging, and computer-aided medicine to improve printing efficiency.

Bioengineered Living Bone Grafts-A Concise Review on Bioreactors and Production Techniques In Vitro

It has been observed that bone fractures carry a risk of high mortality and morbidity. The deployment of a proper bone healing method is essential to achieve the desired success. Over the years, bone tissue engineering (BTE) has appeared to be a very promising approach aimed at restoring bone defects. The main role of the BTE is to apply new, efficient, and functional bone regeneration therapy via a combination of bone scaffolds with cells and/or healing promotive factors (e.g., growth factors and bioactive agents). The modern approach involves also the production of living bone grafts in vitro by long-term culture of cell-seeded biomaterials, often with the use of bioreactors. This review presents the most recent findings concerning biomaterials, cells, and techniques used for the production of living bone grafts under in vitro conditions. Particular attention has been given to features of known bioreactor systems currently used in BTE: perfusion bioreactors, rotating bioreactors, and spinner flask bioreactors. Although bioreactor systems are still characterized by some limitations, they are excellent platforms to form bioengineered living bone grafts in vitro for bone fracture regeneration. Moreover, the review article also describes the types of biomaterials and sources of cells that can be used in BTE as well as the role of three-dimensional bioprinting and pulsed electromagnetic fields in both bone healing and BTE.

Handheld bioprinting strategies for in situ wound dressing

Handheld bioprinting has recently attracted considerable attention as a technology to deliver biomaterials and/or cells to injury sites by using freeform, user-instructed deposition approaches, specifically targeted towards in situ wound dressing and healing. In this review, we present a concise introduction of handheld bioprinting, and a thorough discussion on design and manufacture of handheld bioprinters and choice over bioinks. Finally, the advantages, challenges, and prospective of the said technologies are elaborated. It is believed that handheld bioprinting will play an essential role in the field of in situ wound healing mainly due to its excellent portability, user-friendliness, cost-effectiveness, and amenability to various wound needs.